Building capacity of laboratories is critical in fighting COVID-19

By Samuel Kasibante

COVID-19 is no longer a secret because its aggressive effects are painted all over us through the stress, tears, and retrogress it ushers. These are practically visible through deaths of people around the world, economic recession, and the crippling of health systems.

Whereas the current news item is COVID-19, the world also faces immense danger from many global health threats: some new like COVID-19, Bird flu while others are re-emerging like Yellow fever, diphtheria, rabies among others. The world also faces a great danger of bacteria resisting available drugs that used to work well, for example, resistant HIV, TB, and other bacteria yet the process of drug development is long and very costly.

All these threats are occurring yet the usual killers like malaria, meningitis among others have not moved an inch towards eradication in addition to an epidemiological overlap with non-communicable diseases like cancer, hypertension, injuries, mental illness, and diabetes. This avalanche of diseases threatens economic growth and achievement of development goals since a lot of money is needed to tame their effects at National and personal level besides, the diseases are killing humans who are the basic economic units.

Faced with these threats, countries ought to build resilience through strengthening laboratory-based proactive surveillance systems if we are to detect these diseases much earlier and respond effectively. Epidemiologists are coming to an agreement that COVID-19 may stay with us for a while and may need continuous monitoring to avoid deadly sporadic epidemics. This puts the laboratory at the centre of its management whereby quality samples ought to be collected, tested, and results relayed on time for case management, research, and surveillance.

This calls for purposive strengthening of medical laboratories across the country and research labs in the various universities if we are to contain these epidemics especially COVID-19. So far, the UVRI laboratory has done a commendable job of testing samples for COVID-19 to inform the response. This already shows the central role of clinical laboratories and Laboratory professionals in the fight against diseases.

In the past 10 years, there has been a countrywide emphasis on laboratory capacity building based on ISO standard 15189 geared towards improving the quality of laboratory processes in order to improve the quality of lab results. In-fact the National laboratory policy of 2009 and 2016 both emphasize efforts towards having majority laboratories, especially at the National and Regional level getting International Accreditation based on ISO 15189.

Whereas a lot of gains have been registered, these efforts face a danger of backsliding due to lack of sustainability since funding to these labs has been to a large extent from funders especially the US government. Over time, the US Presidential Emergency Plan for AIDS Relief (PEPFAR) the main source of funding has been cutting funding and reducing its involvement in lab strengthening and this phased pull out keeps mounting pressure on National lab services. The coming of COVID-19 simply complicates the already tense situation manifesting as rampant stock out of reagents, equipment breakdown, etc.

Therefore we need to protect our laboratories through national funding to allow them to collect quality samples, have reagents for testing and building infrastructure that confers biosafety and biosecurity in order to avoid contamination of lab personnel and the communities around. We need to continue building management capacity for effective services stewardship and process improvement in addition to quality services sustainability. COVID-19 is auditing our capacity to handle such epidemics with a high reproductive rate and our resilience may be determined and tested by how equipped our laboratories are.

Lastly, the Medical lab professionals should be motivated through better pay and continuous training to allow them to face our diseases with minimum personal stress and the profession should be further streamlined through the implementation of the lab professionals scheme of service which is now a year and three months old but not implemented. Now that COVID-19 is here to stay, we need to act fast towards building laboratory capacity to handle samples and deliver evidence quickly for an effective and efficient response. This should be planned on purpose, implemented smoothly, and executed in a timely manner.

The writer is a Senior Lab Technologist, Head of Laboratory Department at Jinja Regional Referral Hospital and Master of Public Health student at Makerere University School of Public Health